Article Data

  • Views 630
  • Dowloads 168

Original Research

Open Access

Evaluation of Changes in Muscle Thickness, Bite Force and Facial Asymmetry during Early Treatment of Functional Posterior Crossbite

  • Paula Midori Castelo1,*,
  • Maria Beatriz Duarte Gavião2
  • Luciano José Pereira3
  • Leonardo Rigoldi Bonjardim4

1Department of Biological Sciences, Federal University of São Paulo (UNIFESP), Diadema, Brazil

2Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil

3Department of Physiology, Federal University of Lavras, Lavras, Brazil

4Department of Physiology, Dental School of the Federal University of Sergipe, Sergipe, Brazil

DOI: 10.17796/jcpd.34.4.656rh557093373k4 Vol.34,Issue 4,July 2010 pp.369-374

Published: 01 July 2010

*Corresponding Author(s): Paula Midori Castelo E-mail:


Objective: To determine morphological and functional effects on masticatory system of early treatment of functional posterior crossbite in young children. Study design: 23 children were divided into two groups:deciduous (DecG, n=11) and early mixed dentition (MixG, n=12), which received slow maxillary expansion. Maximal bite force, ultrasonographic masticatory muscle thickness and facial asymmetry were evaluated in three stages: before the start of treatment (s1), after three months of retention (s2), and after three months of observation (s3). The results were analyzed by Mann-Whitney U-test, correlation test, repeated measures ANOVA and backward stepwise multiple regression. Results. Bite force and temporalis thickness increased from s1 to s2 and s3 in both groups (p<0.05). Body mass index (BMI) increased significantly from s1 to s3 only in the MixG, but the masseter thickness did not differ among the stages. The correlation between the angle of the eye and the angle of the mouth in relation to the mid-sagital plane increased from s1 to s3. Masticatory muscle thickness contributed significantly to bite force magnitude in all stages, whereas age and BMI showed no significant contribution to its variation. Conclusion: Bite force and temporalis muscle thickness increased significantly in children after early treatment of functional crossbite.


Ultrasonography; Bite Force; Face; Malocclusion

Cite and Share

Paula Midori Castelo,Maria Beatriz Duarte Gavião,Luciano José Pereira,Leonardo Rigoldi Bonjardim. Evaluation of Changes in Muscle Thickness, Bite Force and Facial Asymmetry during Early Treatment of Functional Posterior Crossbite. Journal of Clinical Pediatric Dentistry. 2010. 34(4);369-374.


1. Malandris M, Mahoney EK. Aetiology, diagnosis and treatment of pos-terior cross-bites in the primary dentition. Int J Paed Dent, 14: 155–166, 2004.

2. Rasheed SA, Prabhu NT, Munshi AK. Electromyographic and ultra-sonographic observations of masseter and anterior temporalis muscles in children. J Clin Pediatr Dent, 20: 127–132, 1996.

3. Sonnesen L, Bakke M, Solow B. Bite force in pre-orthodontic children with unilateral crossbite. Eur J Orthod, 23: 741–749, 2001.

4. Kamegai T, Tatsuki T, Nagano H, Mitsuhashi H, Kumeta J, Tatsuki Y, Kamegai T, Inaba D. A determination of bite force in northern Japanese children. Eur J Orthod, 27: 53–57, 2005.

5. Castelo PM, Gavião MB, Pereira LJ, Bonjardim LR. Masticatory mus-cle thickness, bite force, and occlusal contacts in young children with unilateral posterior crossbite. Eur J Orthod, 29: 149–156, 2007.

6. Kiliaridis S, Katsaros C, Raadsheer MC, Mahboubi PH. Bilateral mas-seter muscle thickness in growing individuals with unilateral crossbite. J Dent Res, 79: 497 [abstract 2831], 2000.

7. Allen D, Rebellato J, Sheats R, Ceron AM. Skeletal and dental contri-butions to posterior crossbites. Angle Orthod, 73: 515–524, 2003.

8. Brin I, Ben-Bassat Y, Blustein Y, Ehrlich J, Hochman N, Marmary Y, Yaffe A. Skeletal and functional effects of treatment for unilateral pos-terior crossbite. Am J Orthod Dentofacial Orthop, 109: 173–179, 1996.

9. Pinto AS, Buschang PH, Throckmorton GS, Chen P. Morphological and positional asymmetries of young children with functional unilateral posterior crossbite. Am J Orthod Dentofacial Orthop, 120: 513–520, 2001.

10. Saitoh I, Hayasaki H, Iwase Y, Nakata M. Improvement in jaw motion following treatment of unilateral crossbite in a child with primary den-tition: a case report. J Craniomand Pract, 20: 129–134, 2002.

11. Ahlgren J. Pattern of chewing and malocclusion of teeth. A clinical study. Acta Odontol Scand, 25: 3–13, 1967.

12. Wickwire NA, Gibbs CH, Jacobson AP, Lundeen HC. Chewing pat-terns in normal children. Angle Orthod, 51: 48–60, 1981.

13. Marinelli A, Alarashi M, Defraia E, Antonini A, Tollaro I. Tooth wear in the mixed dentition: a comparative study between children born in the 1950s and the 1990s. Angle Orthod, 75: 318–321, 2005.

14. Machado Jr AJ, Crespo NA. Cephalometric study of alterations induced by maxillary slow expansion in adults. Rev Bras Otorrinolaringol, 72: 166–172, 2006.

15. Petrén S, Bondemark L, Soderfeldt B. A systematic review concerning early orthodontic treatment of unilateral posterior crossbite. Angle Orthod, 73: 588–596, 2003.

16. Bonjardim LR, Gavião MB, Carmagnani FG, Pereira LJ, Castelo PM. Signs and symptoms of temporomandibular joint dysfunction in chil-dren with primary dentition. J Clin Pediatr Dent, 28: 53–58, 2003.

17. Šlaj M, Ješina MA, Lauc T, Rajić-Meštrović S, Mikšić M. Longitudinal dental arch changes in the mixed dentition. Angle Orthod, 73: 509–514, 2003.

18. Boysen B, La Cour K, Athanasiou AT, Gjessing PE. Three-dimensional evaluation of dentoskeletal changes by quad-helix or removable appli-ances. Br J Orthod, 19: 97–107, 1992.

19. Ferrario VF, Sforza C, Miani A, Tartaglia G. Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop, 103: 327–337, 1993.

20. Bishara SE, Jorgensen GJ, Jakobsen JR. Changes in facial dimensions assessed from lateral and frontal photographs. Part I – Methodology. Am J Orthod Dentofacial Orthop, 108: 389–393, 1995.

21. Pompei VTM, Carvalho AS, Cunha FL, Pompei-Filho H. Evaluation of face asymmetry in individuals with posterior crossbite through frontal photographs. Ortodontia, 38: 337–344, 2005 (in portuguese).

22. Erdinc A, Ugur T, Erbay E. A comparison of different treatment tech-niques for posterior crossbite in the mixed dentition. Am J Orthod Dentofacial Orthop, 116: 287–300, 1999.

23. Kiliaridis S, Mahboubi PH, Raadsheer MC, Katsaros C. Ultrasono-graphic thickness of the masseter muscle in growing individuals with unilateral crossbite. Angle Orthod, 77: 607–611, 2007.

24. Sonnesen L, Bakke M. Bite force in children with unilateral crossbite before and after orthodontic treatment. A prospective longitudinal study. Eur J Orthod 29:310-313, 2007.

25. Chung CH, Font B. Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofacial Orthop, 126: 569–575, 2004.

26. Bakke M, Michler L, Møller E. Clinical significance of isometric bite force versus electrical activity in temporal and masseter muscles. Scand J Dent Res, 97: 539–551, 1989.

27. Kiliaridis S. Muscle function as a determinant of mandibular growth in normal and hypocalcaemic rat. Eur J Orthod, 11: 298–308, 1989.

28. Sonnesen L, Bakke M. Molar bite force in relation to occlusion, cran-iofacial dimensions, and head posture in pre-orthodontic children. Eur J Orthod, 27: 58–63, 2005.

29. Shiau Y-Y, Wang J-S. The effects of dental condition on hand strength and maximum bite force. J Craniomand Pract, 11: 48–54, 1993.

30. Raadsheer MC, van Eijden TM, van Ginkel FC, Prahl-Andersen B. Contribution of jaw muscle size and craniofacial morphology to human bite force magnitude. J Dent Res, 78: 31–42, 1999.

31. Rentes AM, Gavião MB, Amaral JR. Bite force determination in chil-dren with primary dentition. J Oral Rehabil, 29: 1174–1180, 2002.

32. Tabe H, Ueda HM, Kato M, Nagaoka K, Nakashima Y, Matsumoto E, Shikata N, Tanne K. Influence of functional appliances on masticatory muscle activity. Angle Orthod, 75: 616–246, 2005.

33. Braun S, Bantleon HP, Hnat WP, Freudenthaler JW, Marcotte MR, Johnson BE. A study of bite force, part 1: Relationship to various phys-ical characteristics. Angle Orthod, 65: 367–372, 1995.

34. Linderholm H, Lindqvist B, Ringvist M, Wennström A. Isometric bite force in children and its relation to body built and general muscle force. Acta Odontol Scand, 29: 563–568, 1971.

35. Troelstrup B, Møller E. Electromyography of the temporalis and mas-seter muscles in children with unilateral cross-bite. Scand J Dent Res, 78: 425–430, 1970.

36. Georgiakaki I, Tortopidis D, Garefis P, Kiliaridis S. Ultrasonographic thickness and electromyographic activity of masseter muscle of human females. J Oral Rehabil, 34: 121–128, 2007.

37. Langberg BJ, Arai K, Miner RM. Transverse skeletal and dental asym-metry in adults with unilateral lingual posterior crossbite. Am J Orthod Dentofacial Orthop, 127: 6–15, 2005.

38. Padwa BL, Kaiser MO, Kaban LB. Occlusal cant in the frontal plane as a reflection of facial asymmetry. J Oral Maxillofac Surg, 55: 811–816, 1997.

39. Bishara SE, Burkey PS, Kharouf JG. Dental and facial asymmetries: a review. Angle Orthod, 64: 89–98, 1993.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

PubMed (MEDLINE) PubMed comprises more than 35 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time